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Background The mosquito-borne arboviral disease dengue has become a global public health concern. However, very few studies have reported atypical clinical features of dengue among children. Because an understanding of various spectrums of presentation of dengue is necessary for timely diagnosis and management, we aimed to document the typical and atypical clinical features along with predictors of severity among children with dengue during the largest outbreak in Bangladesh in 2019. Methods We conducted a cross-sectional study between August 15 and September 30, 2019. in eight tertiary level hospitals in Dhaka city. Children (aged < 15 years) with serologically confirmed dengue were conveniently selected for data collection through a structured questionnaire. Descriptive, inferential statistics, and multivariable logistic regression were used to analyze data. Results Among the 190 children (mean age 8.8 years, and male-female ratio 1.22:1) included in the analysis, respectively 71.1 and 28.9% children had non-severe and severe dengue. All children had fever with an average temperature of 103.3 ± 1.2 F (SD). Gastrointestinal symptoms were the most common associated feature, including mostly vomiting (80.4%), decreased appetite (79.5%), constipation (72.7%), and abdominal pain (64.9%). Mouth sore, a less reported feature besides constipation, was present in 28.3% of children. Atypical clinical features were mostly neurological, with confusion (21.3%) being the predominant symptom. Frequent laboratory abnormalities were thrombocytopenia (87.2%), leucopenia (40.4%), and increased hematocrit (13.4%). Age (AOR 0.86, 95%CI 0.75–0.98, p = 0.023), mouth sore (AOR 2.69, 95%CI 1.06–6.96, p = 0.038) and a decreased platelet count (< 50,000/mm3) with increased hematocrit (> 20%) (AOR 4.94, 95%CI 1.48–17.31, p = 0.01) were significant predictors of severity. Conclusions Dengue in children was characterized by a high severity, predominance of gastrointestinal symptoms, and atypical neurological presentations. Younger age, mouth sores, and a decreased platelet with increased hematocrit were significant predictors of severity. Our findings would contribute to the clinical management of dengue in children.

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When breast milk is no longer enough to meet the nutritional needs of infants, complementary foods should be added to their diet. It is a very vulnerable period when malnutrition starts in many infants, contributing significantly to high prevalence of malnutrition in under-5 children world-wide. In Bangladesh, complementary feeding (CF) practices are not satisfactory. The objectives of the study were to look into the feeding patterns of under-2 children and to identify the causes which lead mothers/ caregivers to practice inappropriate CF. This cross-sectional study was done in the Pediatric department of Sir Salimullah Medical College Mitford Hospital, Dhaka and in a private chamber from a district town of Bangladesh from October, 2011 to December, 2011. Four hundred mother-child pairs were enrolled by non-random convenience sampling. Different aspects of feeding practices (age of initiation of CF, type of first complementary food, current main complementary food & its quantity, and frequency of CF) were analyzed. Bottle feeding, fast foods and lack of proper family support were most important barriers (p<0.05). High rate of early initiation of CF was mainly due to mothers' perception that breast milk alone was not enough (81.8%) and main cause of late initiation was refusal of complementary foods by their babies (48.4%). Feeding practices were mainly influenced by relatives (25%), qualified doctors (15.3%), neighbors (14.5%) & mother-in-laws (13.5%). CF practices are still far from ideal. Strengthening of nutrition education to mothers/caregivers and family members/relatives along with awareness building in the community may change the wrong practices.

Background: Patients with nephrotic syndrome are susceptible to numerous bacterial, viral, and fungal infections. To design preventive measures, it is vital to identify the various types of infections, their causative organisms, and sensitivity patterns in the local settings. Methods: From January 2012 to July 2014, this descriptive cross-sectional study was conducted in the Pediatric department of Sir Salimullah Medical College, Mitford Hospital, Dhaka. Children younger than 12 years admitted with nephrotic syndrome were screened for infection. Laboratory analysis with culture and sensitivity of urine, blood, CSF, and peritoneal fluids was performed to identify and analyze the causative organisms. Results: The most prevalent age range for the 90 admitted children with nephrotic syndrome was 2-5 years, and the male to female ratio was 0.95:1. 73% of the children had their initial attack of nephrotic syndrome, while 27% had recurrence. During admission, 38% of patients had various infections, and 57% of these infections occurred in children aged 2 to 5 years. Urinary tract infection (UTI), peritonitis, septicemia, and pneumonia were the most prevalent illnesses (incidence, 46%, 26%, 11%, and 9%, respectively). Escherichia coli, Proteus sp., and Streptococcus sp., commonly caused urinary tract infections, peritonitis, septicemia, and pneumonia. Organisms for UTI, peritonitis and pneumonia were sensitive to ciprofloxacin, azithromycin, and ceftriaxone, respectively. Conclusion: Infection should be ruled out carefully in every case of nephrotic syndrome during management in the hospital. Escherichia coli is the dominant causative agent for UTI. After sending relevant body fluids for culture sensitivity, ciprofloxacin for a suspected UTI, and azithromycin for peritonitis can be started immediately.